Use and costs of medical care for children and adolescents with and without Attention-Deficit/Hyperactivity disorder

Context A shortage of data exists on medical care use by persons with atten tion-deficit/hyperactivity disorder (ADHD), Objective To compare medical care use and costs among persons with and with out ADHD. Design and Setting Population-based cohort study conducted in Rochester, Mi nn. Subjects All children born in 1976-1982 were followed up through 1995, usin g school and medical records to identify those with ADHD, The 4880 birth co hort members (mean age, 7.3 years) still residing in Rochester in 1987 were followed up in medical facility-linked billing databases until death, emig ration, or December 31, 1995, Main Outcome Measures Clinical diagnoses, likelihood and frequency of inpat ient and outpatient hospitalizations, emergency department (ED) visits, and total medical costs (including ambulatory care), compared among individual s with and without ADHD, Results Among the 4119 birth cohort members who remained in the area throug h 1995 (mean age, 15.3 years), 7.5% (n=309) had met criteria for ADHD, Comp ared with persons without ADHD, those with ADHD were more likely to have di agnoses in multiple categories, including major injuries (59% vs 49%; P<.00 1) and asthma (22% vs 13%; P<.001). The proportion with any hospital inpati ent, hospital outpatient, or ED admission was higher for persons with ADHD vs those without ADHD (26% vs 18% [P<.001], 41% vs 33% [P=.006], and 81% vs 74% [P=.005], respectively). The 9-year median costs for persons with ADHD corn pared with those without ADHD were more than double ($4306 vs $1944; P<.001), even for the subset with no hospital or ED admissions (eg, median 1987 costs, $128 vs $65; P<.001), The differences between individuals with and without ADHD were similar for males and females and across age groups. Conclusion In our cohort, compared with persons without ADHD, those with AD HD substantially greater use of medical care in multiple care delivery sett ings.